gms | German Medical Science

129. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

24.04. - 27.04.2012, Berlin

Investigation of the infiltration zone of brain metastases from various primaries: preliminary data of a prospective monocentric study

Meeting Abstract

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  • Claudia Lindner - Universitätsklinikum Dresden, Neurochirurgie, Dresden
  • Gabriele Schackert - Neurochirurgie, Neurochirurgie, Dresden

Deutsche Gesellschaft für Chirurgie. 129. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 24.-27.04.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgch241

DOI: 10.3205/12dgch241, URN: urn:nbn:de:0183-12dgch2416

Veröffentlicht: 23. April 2012

© 2012 Lindner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: It has long believed that brain metastases are well circumscribed lesions without infiltration zone, being a good target for surgical treatment. Recent publications could demonstrate that also an infiltration zone exists around brain metastases and that the depth of infiltration might vary between the different primaries.The goal of our prospective study was to investigate the infiltration zone around cerebral lesions of different primaries by taking biopsies out of the surrounding tissue.

Materials and methods: Between 2009 and 2011, 45 patients with brain metastases of different primaries, located in non-eloquent areas were enrolled in a prospective clinical trial after written consent. The study was approved by the local ethics committee, No 102042009. During surgery, whenever possible, en-bloc resection was performed. At the end of the procedure, biopsies were taken out of the adjacent tissue for histopathological examination. All tissues were examined for infiltration of cancer cells by immunohistochemistry. SPSS was applied for statistics.

Results: 45% females and 55% males with brain metastases were enrolled in our study. The most common primaries were: lung (39%), kidney (15%), and malignant melanoma (12%). The median age was 65 years . All patients received an early MRI with contrast medium within 48 hours after surgery, confirming the complete resection of tbe lesion. In 14 patients (31.1%), tumor cells were detected in at least one of the taken biopsies. The distribution between the different primaries was different. Some patients without tumor cells in the adjacent tissue develepod local recurrences without following XRT.

Conclusion: Despite complete microsurgical resection of brain metastases confirmed by early MRI, we demonstrate that tumor cells infiltrate the adjacent tissue. The extent of the infiltration zone remains unpredictable. The assessment of tumor margin requires additional diagnostic tools. Thise preliminary results support the routine post-operative XRT, even if single metastases were completely resected.